Alcoholism

A Widespread Problem

Currently, nearly 14 million Americans—1 in every 13 adults-abuse
alcohol or are alcoholic. Several million more adults engage in risky
drinking patterns that could lead to alcohol problems. In addition,
approximately 53 percent of men and women in the United States report that
one or more of their close relatives have a drinking problem.

What Is Alcoholism?

Alcoholism is a disease that is characterized by the following:

Craving: A strong need, or compulsion, to drink.

Loss of control: The frequent inability to stop drinking once a
person has begun.

Physical dependence: The occurrence of withdrawal symptoms, such as
nausea, sweating, shakiness, and anxiety, when alcohol use is stopped
after a period of heavy drinking. These symptoms are usually relieved by
drinking alcohol or by taking another sedative drug.

Tolerance: The need for increasing amounts of alcohol in order to
get “high.”

Alcoholism has little to do with what kind of alcohol one drinks, how
long one has been drinking, or even exactly how much alcohol one consumes.
But it has a great deal to do with a person's uncontrollable need for
alcohol. This description of alcoholism helps us understand why most
alcoholics can't just “use a little willpower” to stop
drinking. He or she is frequently in the grip of a powerful craving for
alcohol, a need that can feel as strong as the need for food or water.
While some people are able to recover without help, the majority of
alcoholic individuals need outside assistance to recover from their
disease. With support and treatment, many individuals are able to stop
drinking and rebuild their lives. Many people wonder: why can some
individuals use alcohol without problems, while others are utterly unable
to control their drinking? Recent research has demonstrated that for many
people a vulnerability to alcoholism is inherited. Yet it is important to
recognize that aspects of a person's environment, such as peer pressure
and the availability of alcohol, also are significant influences. Both
inherited and environmental influences are called “risk
factors.” But risk is not destiny. Just because alcoholism tends to
run in families doesn't mean that a child of an alcoholic parent will
automatically develop alcoholism.

What Is Alcohol Abuse?

Alcohol abuse differs from alcoholism in that it does not include an
extremely strong craving for alcohol, loss of control, or physical
dependence. In addition, alcohol abuse is less likely than alcoholism to
include tolerance (the need for increasing amounts of alcohol to get
“high”). Alcohol abuse is defined as a pattern of drinking
that is accompanied by one or more of the following situations within a
12-month period:

failure to fulfill major work, school, or home
responsibilities;

drinking in situations that are physically dangerous, such as while
driving a car or operating machinery;

recurring alcohol-related legal problems, such as being arrested for
driving under the influence of alcohol or for physically hurting someone
while drunk;

continued drinking despite having ongoing relationship problems that
are caused or worsened by the effects of alcohol.

While alcohol abuse is basically different from alcoholism, it is
important to note that many effects of alcohol abuse are also experienced
by alcoholics.

Alcoholism Treatment

The nature of treatment depends on the severity of an individual's
alcoholism and the resources that are available in his or her community.
Treatment may include detoxification (the process of safely getting
alcohol out of one's system); taking doctor-prescribed medications, such
as disulfiram (Antabuse®) or naltrexone (ReVia™) to help prevent
a return to drinking once drinking has stopped; and individual and/or
group counseling. There are promising types of counseling that teach
recovering alcoholics to identify situations and feelings that trigger the
urge to drink and to find new ways to cope that do not include alcohol
use. Any of these treatments may be provided in a hospital or residential
treatment setting or on an outpatient basis.

Because the involvement of family members is important to the recovery
process, many programs also offer brief marital counseling and family
therapy as part of the treatment process. Some programs also link up
individuals with vital community resources, such as legal assistance, job
training, child care, and parenting classes.

Alcoholics Anonymous

Virtually all alcoholism treatment programs also include meetings of
Alcoholics Anonymous (AA), which describes itself as a “worldwide
fellowship of men and women who help each other to stay sober.”
While AA is generally recognized as an effective mutual help program for
recovering alcoholics, not everyone responds to AA's style and message,
and other recovery approaches are available. Even those who are helped by
AA usually find that AA works best in combination with other elements of
treatment, including counseling and medical care.

Can Alcoholism Be Cured?

While alcoholism is a treatable disease, a cure is not yet available.
That means that even if an alcoholic has been sober for a long while and
has regained health, he or she remains susceptible to relapse and must
continue to avoid all alcoholic beverages. “Cutting down” on
drinking doesn't work; cutting out alcohol is necessary for a successful
recovery.

However, even individuals who are determined to stay sober may suffer
one or several “slips,” or relapses, before achieving
long-term sobriety. Relapses are very common and do not mean that a person
has failed or cannot eventually recover from alcoholism. Keep in mind,
too, that every day that a recovering alcoholic has stayed sober prior to
a relapse is extremely valuable time, both to the individual and to his or
her family. If a relapse occurs, it is very important to try to stop
drinking once again and to get whatever additional support is needed to
abstain from drinking.

Resources

For more information on alcohol abuse and alcoholism, contact the
following organizations: